A 54-year-old gentleman from Bangladesh, came with complaints of splenic lesion and enlarged para-aortic lymph nodes for further treatment. He had already undergone CT guided biopsy of para-aortic lymph node, which was non-diagnostic. Following this, he underwent laparoscopic biopsy of para-aortic lymph node, which again turned out to be non-diagnostic.
He visited Apollo Specialty Hospital, Vanagaram, Chennai to consult Dr Anita Ramesh, Medical Oncologist. After detailed discussion of the case and in view of previous 2 negative biopsy results, Dr. Sanjeeb Kumar Agarwal decided to go ahead with splenic mass biopsy. Patient and his relatives were explained about the risk factors and with their consent ultrasound guided splenic lesion biopsy was done. A 18G/20T trucut biopsy gun to get adequate tissue, as the team didn’t want to get one more inconclusive result. With 4 passes, satisfactory tissue material was taken. There was no complications and patient was discharged next day. Pathologist gave a confident diagnosis of Lymphoma.
Dr. Sanjeeb Kumar Agarwal said “There is a common misbelief that we should not do splenic biopsy. Even if very few people do this, they use 20G biopsy gun which may not yield adequate tissue material. If one will go through the clinical literature, then there are many standard articles saying we can use 18G trucut biopsy gun and do splenic lesion biopsy if strongly needed.”